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A possible merger of Minnesota-based Fairview Health Services and South Dakota-based Sanford Health could put the University of Minnesota Medical Center in the hands of a company without strong ties to the Twin Cities, according to Minnesota Attorney General Lori Swanson. A public hearing has been set for Sunday. Representatives of the health groups say negotiations are not at an advanced stage.

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South Dakota-based health care systems showcase two ways to provide telehealth services using a large-scale model. Avera Health's e-care hub, which supports 32 hospitals in six states, includes a central e-ICU that contracts with hospitals throughout the upper Midwest, while Sanford Health, which serves 100 locations, does not use a central hub and prefers to keep physicians in clinics to respond to patient needs.

The Missouri House has given preliminary approval to legislation to revive a $350,000 cap on damages in medical-malpractice lawsuits. The bill excludes provisions of a measure passed last year that were ruled to be unconstitutional by the state Supreme Court.

The Minnesota Legislature on Monday approved a plan to create a health insurance exchange, in a 39-28 Senate vote. The legislation, approved earlier by the House, now goes to Gov. Mark Dayton, a Democrat, who has said he will sign it and whose administration already has begun work on building the exchange.

A Minnesota bill that would force hospitals to meet nurse staffing standards may be stalled in the state Legislature. A committee leader wants hospitals and nurses to move toward a consensus before a hearing is scheduled.

A Minnesota Health Care Reform Task Force report called for nurse practitioners to be allowed to work independently of physicians to help address a shortage of primary care providers. Task force member Dr. Therese Zink said the reality is the state "can't afford to wait." Seventeen states, including Iowa and North Dakota, permit advanced practice nurses to practice independently.